Adnan M. Ali, Afaq Naeem, Laiba Naseer, N. Naeem, S. Waheed, M. Mastoor
Aim: The present study aimed to determine the frequency and association of hypogonadism in men with type 2 diabetes mellitus. Material and Methods: This cross-sectional study was conducted on 242 type 2 DM male patients in the Department of General Medicine, Bahria International Hospital, Lahore from 16th January 2022 to 15th July 2022. The Androgen deficiency in aging male (ADAM) questionnaire was used for screening hypogonadal symptoms in the study group. The presence of low serum testosterone below 3 ng/mL and positive ADAM score was referred to as hypogonadism. T2DM patients with and without hypogonadism had their clinical and biochemical variables compared. Total testosterone, BMI, free testosterone, waist circumference, and sex hormone–binding globulin were measured. SPSS version 26 was used for data analysis. Results: Of the total 242 T2DM male patients, the prevalence of hypogonadism was 24.8% (n=60). The most prevalent symptoms in T2DM patients were hypogonadal symptoms. The overall mean age was 45.8± 9.63 years with range (25-70 years). Mean BMI value was 24.8 ± 3.64 kg/m2. The incidence of overweight and obese patients were 17.8% and 49.3% respectively. The prevalence of erectile dysfunction, reduced libido, and work performance deterioration in hypogonadism were 94.8%, 68.2%, and 56.3% respectively. T2DM patients without hypogonadism had lower a) incidence of diabetic neuropathy (18.6% vs. 43.8%; p=0.021), b) T2DM duration (5.3± 3.82 vs. 9.2± 4.9 years; P=0.002), c) occurrence of diabetic retinopathy (26.9% vs. 57.8%; P=0.006), and d) HbA1c (8.9± 1.53% vs. 9.9 ± 2.54%: P=0.005), and insulin therapy (21.5% vs. 45.8%: P=0.031) compared to those with hypogonadism. Conclusion: The present study found that prevalence of hypogonadism was 24.8% in type 2 diabetes mellitus. Patients with hypogonadism had higher HbA1c, higher prevalence of neuropathy and retinopathy, longer diabetic duration, and predominantly used insulin therapy than those T2DM patients without hypogonadism. Keywords: Hypogonadism, Type 2 diabetes mellitus, Androgen deficiency in aging male (ADAM).
目的:本研究旨在确定男性2型糖尿病患者性腺功能减退的频率及其相关性。材料和方法:本横断面研究于2022年1月16日至2022年7月15日在拉合尔巴利亚国际医院普通内科进行的242例2型糖尿病男性患者。在研究组中，使用衰老男性雄激素缺乏(ADAM)问卷来筛选性腺功能减退症状。血清睾酮水平低于3 ng/mL，且ADAM评分呈阳性，称为性腺功能减退。比较伴有和不伴有性腺功能减退的T2DM患者的临床及生化指标。测量总睾酮、BMI、游离睾酮、腰围和性激素结合球蛋白。使用SPSS version 26进行数据分析。结果:242例男性T2DM患者中，性腺功能减退的患病率为24.8% (n=60)。T2DM患者最常见的症状是性腺功能减退症状。总体平均年龄为45.8±9.63岁，年龄范围为25 ~ 70岁。BMI平均值为24.8±3.64 kg/m2。超重和肥胖患者的发生率分别为17.8%和49.3%。性腺功能减退患者勃起功能障碍、性欲下降和工作表现下降的患病率分别为94.8%、68.2%和56.3%。无性腺功能减退的T2DM患者糖尿病性神经病变发生率较低(18.6% vs. 43.8%;p=0.021)， b) T2DM病程(5.3±3.82∶9.2±4.9年);P=0.002)， c)糖尿病视网膜病变发生率(26.9% vs. 57.8%;P=0.006)， d) HbA1c(8.9±1.53% vs. 9.9±2.54%:P=0.005)，胰岛素治疗(21.5% vs. 45.8%: P=0.031)。结论:2型糖尿病患者性腺功能减退的发生率为24.8%。与无性腺功能减退的T2DM患者相比，性腺功能减退患者HbA1c较高，神经病变和视网膜病变患病率较高，糖尿病病程较长，且主要使用胰岛素治疗。关键词:性腺功能减退，2型糖尿病，老年男性雄激素缺乏(ADAM)
{"title":"Frequency and Correlation of Hypogonadism in Men with Type 2 Diabetes","authors":"Adnan M. Ali, Afaq Naeem, Laiba Naseer, N. Naeem, S. Waheed, M. Mastoor","doi":"10.53350/pjmhs221610393","DOIUrl":"https://doi.org/10.53350/pjmhs221610393","url":null,"abstract":"Aim: The present study aimed to determine the frequency and association of hypogonadism in men with type 2 diabetes mellitus. Material and Methods: This cross-sectional study was conducted on 242 type 2 DM male patients in the Department of General Medicine, Bahria International Hospital, Lahore from 16th January 2022 to 15th July 2022. The Androgen deficiency in aging male (ADAM) questionnaire was used for screening hypogonadal symptoms in the study group. The presence of low serum testosterone below 3 ng/mL and positive ADAM score was referred to as hypogonadism. T2DM patients with and without hypogonadism had their clinical and biochemical variables compared. Total testosterone, BMI, free testosterone, waist circumference, and sex hormone–binding globulin were measured. SPSS version 26 was used for data analysis. Results: Of the total 242 T2DM male patients, the prevalence of hypogonadism was 24.8% (n=60). The most prevalent symptoms in T2DM patients were hypogonadal symptoms. The overall mean age was 45.8± 9.63 years with range (25-70 years). Mean BMI value was 24.8 ± 3.64 kg/m2. The incidence of overweight and obese patients were 17.8% and 49.3% respectively. The prevalence of erectile dysfunction, reduced libido, and work performance deterioration in hypogonadism were 94.8%, 68.2%, and 56.3% respectively. T2DM patients without hypogonadism had lower a) incidence of diabetic neuropathy (18.6% vs. 43.8%; p=0.021), b) T2DM duration (5.3± 3.82 vs. 9.2± 4.9 years; P=0.002), c) occurrence of diabetic retinopathy (26.9% vs. 57.8%; P=0.006), and d) HbA1c (8.9± 1.53% vs. 9.9 ± 2.54%: P=0.005), and insulin therapy (21.5% vs. 45.8%: P=0.031) compared to those with hypogonadism. Conclusion: The present study found that prevalence of hypogonadism was 24.8% in type 2 diabetes mellitus. Patients with hypogonadism had higher HbA1c, higher prevalence of neuropathy and retinopathy, longer diabetic duration, and predominantly used insulin therapy than those T2DM patients without hypogonadism. Keywords: Hypogonadism, Type 2 diabetes mellitus, Androgen deficiency in aging male (ADAM).","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131968073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Samreen, M. Hakeem, Hafsah Zaheer, Ambreen Raza, A. G. Billoo
Introduction: The lumbar puncture is frequently used in medical facilities to collect data on the cerebrospinal fluid (CSF). The method aids in the diagnosis of conditions affecting the spine and brain's central nervous system. However, in routine practice out of the many challenges posed by the parents due to lack of education, denial of consent for this procedure is a great challenge at clinical settings. Objectives: To determine the association of various factors with parental refusal for lumbar puncture among pediatric population (age from 1 moth to 18 years). Materials and Methods: A descriptive, cross-sectional study was carried out at the department of pediatrics and child health and department of Emergency at Aga Khan University Hospital, Karachi from June 2017 to May 2018. A total of 178 children 1 month to 18 years old admitted with febrile fits, suspected meningitis or encephalitis who were advised for lumber puncture were included. Results: In the present study, the age of the patients ranged from 1 month to 18 year. Majority of the patients 153 (85.39%) were between 1 month to 6 years of age. There were 115 (64.61%) male patients.. Fever and fits was the most frequent indication (n=151, 84.83%) for lumber puncture in the study. Most of the parents were educated, 68.54% of mothers and 65.17% fathers had graduate level of education, and parents of 47 (26.4%) patients refused for lumber puncture. Conclusion: This study concluded that frequency of parental refusal for lumbar puncture was 26.4% and the most common reason for refusal was fear of complications. Keywords: lumbar puncture, febrile seizures, parental refusal.
{"title":"Factors Associated with Parental Refusal for Lumber Puncture Among Children and Adolescent: A Cross Sectional Survey at a Tertiary Care Hospital","authors":"S. Samreen, M. Hakeem, Hafsah Zaheer, Ambreen Raza, A. G. Billoo","doi":"10.53350/pjmhs221610442","DOIUrl":"https://doi.org/10.53350/pjmhs221610442","url":null,"abstract":"Introduction: The lumbar puncture is frequently used in medical facilities to collect data on the cerebrospinal fluid (CSF). The method aids in the diagnosis of conditions affecting the spine and brain's central nervous system. However, in routine practice out of the many challenges posed by the parents due to lack of education, denial of consent for this procedure is a great challenge at clinical settings. Objectives: To determine the association of various factors with parental refusal for lumbar puncture among pediatric population (age from 1 moth to 18 years). Materials and Methods: A descriptive, cross-sectional study was carried out at the department of pediatrics and child health and department of Emergency at Aga Khan University Hospital, Karachi from June 2017 to May 2018. A total of 178 children 1 month to 18 years old admitted with febrile fits, suspected meningitis or encephalitis who were advised for lumber puncture were included. Results: In the present study, the age of the patients ranged from 1 month to 18 year. Majority of the patients 153 (85.39%) were between 1 month to 6 years of age. There were 115 (64.61%) male patients.. Fever and fits was the most frequent indication (n=151, 84.83%) for lumber puncture in the study. Most of the parents were educated, 68.54% of mothers and 65.17% fathers had graduate level of education, and parents of 47 (26.4%) patients refused for lumber puncture. Conclusion: This study concluded that frequency of parental refusal for lumbar puncture was 26.4% and the most common reason for refusal was fear of complications. Keywords: lumbar puncture, febrile seizures, parental refusal.","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115124867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Salma Sadia, Nishat Akram, Sana Gull, Hina Aftab, M. Akram, Rehana Kanwal, Hafiz Irfan Shahzad
Background: During pregnancy, amniotic fluid indicates the normal placental function. It is the most essential element for surveillance of fetal growth and health. Amniotic fluid index (AFI) is the most ideal way to determine the level of amniotic fluid during pregnancy. However, the single deepest pocket is applied to determine the changes in AFI level in pregnancies suspected to oligohydramnios. Borderline AFI is defined as AFI levels > 5 to < 10cm; it is a challenging task in obstetrics to associate it with adverse pregnancy outcomes. Objective: To assess the perinatal outcomes in patients with borderline AFI. Study Design: Cross-sectional. Setting: Department of Obstetrics & Gynaecology, Sharif Medical City Hospital, Lahore. Study Duration: Study was carried out over a period of six months from 10-11-2020 to 11-05-2021. Subjects And Methods: A total of 160 patients having borderline AFI (more than 5 and less than 10cm) were included in the study. Perinatal outcomes were assessed at the time of delivery in the hospital. Data Analysis Method: Stratification of data was carried out with regard to age, gestational age, parity and area of residence. Results: Mean age of the patients was 25.17±4.90 years. Mean gestational age was observed to be 38.44±1.54 weeks. Majority of the patients were between Para 0 to 3. There was no smoker in preset study. Most of the patients belonged to rural area. Perinatal outcomes were as follows: Intrapartum fetal distress was observed in 64 (40%), meconium staining in 56 (35%), Apgar score < 10 at 5 minutes in 37 patients (23.1%) and NICU admission in 38 (23.8%). Conclusion: In conclusion, borderline AFI during pregnancy can lead to severe hazardous consequences. Therefore, pregnancy complicated with borderline AFI must be observed carefully in order to improve the outcome of pregnancy and avoid adverse perinatal outcomes. Keywords: Borderline AFI, Apgar Score, NICU Admission, Intrapartum Fetal Distress, Meconium Staining.
{"title":"Perinatal Outcome in Patients with Borderline AFI","authors":"Salma Sadia, Nishat Akram, Sana Gull, Hina Aftab, M. Akram, Rehana Kanwal, Hafiz Irfan Shahzad","doi":"10.53350/pjmhs221610256","DOIUrl":"https://doi.org/10.53350/pjmhs221610256","url":null,"abstract":"Background: During pregnancy, amniotic fluid indicates the normal placental function. It is the most essential element for surveillance of fetal growth and health. Amniotic fluid index (AFI) is the most ideal way to determine the level of amniotic fluid during pregnancy. However, the single deepest pocket is applied to determine the changes in AFI level in pregnancies suspected to oligohydramnios. Borderline AFI is defined as AFI levels > 5 to < 10cm; it is a challenging task in obstetrics to associate it with adverse pregnancy outcomes. Objective: To assess the perinatal outcomes in patients with borderline AFI. Study Design: Cross-sectional. Setting: Department of Obstetrics & Gynaecology, Sharif Medical City Hospital, Lahore. Study Duration: Study was carried out over a period of six months from 10-11-2020 to 11-05-2021. Subjects And Methods: A total of 160 patients having borderline AFI (more than 5 and less than 10cm) were included in the study. Perinatal outcomes were assessed at the time of delivery in the hospital. Data Analysis Method: Stratification of data was carried out with regard to age, gestational age, parity and area of residence. Results: Mean age of the patients was 25.17±4.90 years. Mean gestational age was observed to be 38.44±1.54 weeks. Majority of the patients were between Para 0 to 3. There was no smoker in preset study. Most of the patients belonged to rural area. Perinatal outcomes were as follows: Intrapartum fetal distress was observed in 64 (40%), meconium staining in 56 (35%), Apgar score < 10 at 5 minutes in 37 patients (23.1%) and NICU admission in 38 (23.8%). Conclusion: In conclusion, borderline AFI during pregnancy can lead to severe hazardous consequences. Therefore, pregnancy complicated with borderline AFI must be observed carefully in order to improve the outcome of pregnancy and avoid adverse perinatal outcomes. Keywords: Borderline AFI, Apgar Score, NICU Admission, Intrapartum Fetal Distress, Meconium Staining.","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116044520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dost Mohammad Sohu, R. Muhammad, Suresh Kumar, H. Ghumro, Z. Soomro, Kashif Ali Shaikh, Aijaz Ali Maitlo, Fazallullah Mahar
Objective: To estimate the incidence of pre-operative deep vein thrombosis in patients with post-hip fractures. Study Design: Prospective study Place and Duration of Study: Department of Orthopaedic Surgery, Jinnah Postgraduate Medical Centre, Karachi from 1st January 2019 to 31st December 2021. Methodology: One hundred cases hip fractures which were analyzed for incidence of deep vein thrombosis. Three types of tests were used for confirmation including ultrasonography, computed topography and the venography. In cases where identification of deep vein thrombosis was confirmed the implantation of inferior vena cava filters was ensured. Results: There were seven such cases that were having deep vein thrombosis presentation in them while rest of 93% did not have any clinical presentation for deep vein thrombosis with their hip fracture. The incidence of the pre operative deep vein thrombosis was significantly higher in cases that were brought after 72 hours deep vein thrombosis was highest in cases that were within the age bracket of 70-79 years. Conclusion: A lower incidence as 7% of deep vein thrombosis occurs in pre operative cases of hip fracture. Keywords: Incidence, Deep vein thrombosis, Post-hip fracture
{"title":"Incidence of Pre-Operative Deep Vein Thrombosis in Patients with Post-Hip Fractures","authors":"Dost Mohammad Sohu, R. Muhammad, Suresh Kumar, H. Ghumro, Z. Soomro, Kashif Ali Shaikh, Aijaz Ali Maitlo, Fazallullah Mahar","doi":"10.53350/pjmhs221610331","DOIUrl":"https://doi.org/10.53350/pjmhs221610331","url":null,"abstract":"Objective: To estimate the incidence of pre-operative deep vein thrombosis in patients with post-hip fractures. Study Design: Prospective study Place and Duration of Study: Department of Orthopaedic Surgery, Jinnah Postgraduate Medical Centre, Karachi from 1st January 2019 to 31st December 2021. Methodology: One hundred cases hip fractures which were analyzed for incidence of deep vein thrombosis. Three types of tests were used for confirmation including ultrasonography, computed topography and the venography. In cases where identification of deep vein thrombosis was confirmed the implantation of inferior vena cava filters was ensured. Results: There were seven such cases that were having deep vein thrombosis presentation in them while rest of 93% did not have any clinical presentation for deep vein thrombosis with their hip fracture. The incidence of the pre operative deep vein thrombosis was significantly higher in cases that were brought after 72 hours deep vein thrombosis was highest in cases that were within the age bracket of 70-79 years. Conclusion: A lower incidence as 7% of deep vein thrombosis occurs in pre operative cases of hip fracture. Keywords: Incidence, Deep vein thrombosis, Post-hip fracture","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133849412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ramsha Shahzeen, Zaeem Sibtain, N. Ahmed, Muhammad Affan Qaiser, Nazish Butt, Ghulam Muhammad
Objective: Diagnosing liver fibrosis without resorting to invasive surgery is in high demand but underserved. The focus of this study is on the diagnostic accuracy of MRI and the transient elastography fibro scan for liver fibrosis. Methodology: After the ethical approval from institute review board, sixty patients with liver fibrosis were selected by random sampling technique underwent multiparametric MR, transesophageal echocardiography (TE), and blood testing in this single-center cross-sectional study. Noninvasive treatment alternatives were weighed against histological information including stage and grade (such as MR fat and iron content). The diagnostic accuracy of each method for F3 and F4 hepatic fibrosis, as well as for advanced fibrosis, was evaluated using ROC curve analysis. Each technique was evaluated based on its accuracy (F3–F4). Results: Magnetic resonance elastography was used to find significant correlations between fibrosis stage and collagen content (r = 0.66; P = 0.001), as well as between inflammatory grade and collagen content (r = 0.53; P = 0.036). The MRE, TE, DCE-MRI, DWI, and APRI all had AUCs of 0.78 or above, while the AUC for identifying advanced fibrosis was 0.71. Advanced fibrosis AUC values were between 0.94 and 0.77, 0.79 and 0.79, and 0.70 and 0.70. (F3–F4). Practical implication: This study will to determine which diagnostic technique is better suited to accurately diagnose the liver fibrosis patients. Conclusion: The strongest correlation was seen between histological markers and MRI. The ability of magnetic resonance imaging to detect advanced liver fibrosis and cirrhosis was also superior to that of transient elastography fibro scans. Keywords: MRI, Liver fibrosis, diagnostic accuracy, transient elastography fibro scan
{"title":"Comparison of Diagnostic Accuracy of Magnetic Resonance Imaging and Transient Elastography Fibro Scan for Detecting Liver Fibrosis","authors":"Ramsha Shahzeen, Zaeem Sibtain, N. Ahmed, Muhammad Affan Qaiser, Nazish Butt, Ghulam Muhammad","doi":"10.53350/pjmhs221610426","DOIUrl":"https://doi.org/10.53350/pjmhs221610426","url":null,"abstract":"Objective: Diagnosing liver fibrosis without resorting to invasive surgery is in high demand but underserved. The focus of this study is on the diagnostic accuracy of MRI and the transient elastography fibro scan for liver fibrosis. Methodology: After the ethical approval from institute review board, sixty patients with liver fibrosis were selected by random sampling technique underwent multiparametric MR, transesophageal echocardiography (TE), and blood testing in this single-center cross-sectional study. Noninvasive treatment alternatives were weighed against histological information including stage and grade (such as MR fat and iron content). The diagnostic accuracy of each method for F3 and F4 hepatic fibrosis, as well as for advanced fibrosis, was evaluated using ROC curve analysis. Each technique was evaluated based on its accuracy (F3–F4). Results: Magnetic resonance elastography was used to find significant correlations between fibrosis stage and collagen content (r = 0.66; P = 0.001), as well as between inflammatory grade and collagen content (r = 0.53; P = 0.036). The MRE, TE, DCE-MRI, DWI, and APRI all had AUCs of 0.78 or above, while the AUC for identifying advanced fibrosis was 0.71. Advanced fibrosis AUC values were between 0.94 and 0.77, 0.79 and 0.79, and 0.70 and 0.70. (F3–F4). Practical implication: This study will to determine which diagnostic technique is better suited to accurately diagnose the liver fibrosis patients. Conclusion: The strongest correlation was seen between histological markers and MRI. The ability of magnetic resonance imaging to detect advanced liver fibrosis and cirrhosis was also superior to that of transient elastography fibro scans. Keywords: MRI, Liver fibrosis, diagnostic accuracy, transient elastography fibro scan","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"212 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133643396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Tunneled central venous catheters (CVC) is a flexible tube with prolonged vascular access providing for the management of intravenous medication treatments, fluids, or total parenteral nutrition, repeated blood sampling, and hemodialysis (HD). Objectives: The main objective of the study is to investigate the risk factors for tunneled hemodialysis catheter dysfunction. Material and methods: This observational study was conducted in Akbar Niazi Teaching Hospital, Barakahu, Islamabad during June 2022 till October 2022. All patients who underwent central venous catheterization for the first time in the hospital were included in the study. All catheterizations were performed ultrasound-guided and rechecked by fluoroscopy to confirm the proper replacement of the catheter in the Cava-atrial junction. Results: The data was collected from 235 patients. One hundred sixty-three patients (72.4%) had no CVC malfunction and sixty-two (27.6%) patients had malfunction. The median duration of follow-up was 162 days for patients with no malfunction and 48.5 days for patients with CVC malfunction. Practical implication: We can easily find the catheter related complications after reading this research analysis. Conclusion: It is concluded that the placement of TDCs in patients should be considered the last resort; however, with the increased use of TDCs and experience, the number of catheter-related complications can be expected to decrease. Keywords: TDCs, Catheter, CVC, Malfunction, Complications
{"title":"Investigation of Risk Factors for Tunneled Hemodialysis Catheter Dysfunction","authors":"K. Rehman, R. Qazi, K. Hussain","doi":"10.53350/pjmhs221610469","DOIUrl":"https://doi.org/10.53350/pjmhs221610469","url":null,"abstract":"Introduction: Tunneled central venous catheters (CVC) is a flexible tube with prolonged vascular access providing for the management of intravenous medication treatments, fluids, or total parenteral nutrition, repeated blood sampling, and hemodialysis (HD). Objectives: The main objective of the study is to investigate the risk factors for tunneled hemodialysis catheter dysfunction. Material and methods: This observational study was conducted in Akbar Niazi Teaching Hospital, Barakahu, Islamabad during June 2022 till October 2022. All patients who underwent central venous catheterization for the first time in the hospital were included in the study. All catheterizations were performed ultrasound-guided and rechecked by fluoroscopy to confirm the proper replacement of the catheter in the Cava-atrial junction. Results: The data was collected from 235 patients. One hundred sixty-three patients (72.4%) had no CVC malfunction and sixty-two (27.6%) patients had malfunction. The median duration of follow-up was 162 days for patients with no malfunction and 48.5 days for patients with CVC malfunction. Practical implication: We can easily find the catheter related complications after reading this research analysis. Conclusion: It is concluded that the placement of TDCs in patients should be considered the last resort; however, with the increased use of TDCs and experience, the number of catheter-related complications can be expected to decrease. Keywords: TDCs, Catheter, CVC, Malfunction, Complications","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124859703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asma Akhter, H. Bashir, Summaira Perveen, Sajilah Karim, A. Khakwani, Mirab Badar, Huma Quddussi
Objective: To find out the current status of prevention of neonatal hypothermia by firstly, initialization of immediate drying and skin to skin contact of all newborns delivered by spontaneous vaginal delivery, and secondly, to initiate early breast feeding. Methodology: This was an observational study carried out in labor room of Gyne Unit 1, Nishtar Medical University (NMU) and Hospital, Multan Pakistan from April to September 2019. Based on “Point of Care Quality Improvement (POCQI)” guidelines, Initially, data were collected for 4 weeks during morning shift (phase 1) utilizing 2 indicators i-e immediate drying and number of babies who developed hypothermia within one hour of birth. Data were analyzed; results interpreted, and necessary modifications made. After implementation of changes further data was collected for 24 hours shift of gyne unit 1 for the rest of study period including additional indicators i.e., initiation of early breastfeeding and skin to skin contact. Results: A total of 744 babies delivered over a period of six months during this initiative, which was carried out in 2 phases, the phase-1 comprised of four weeks and included study of 24 babies and the phase 2 included 720 babies over five months. During phase-1, all 24 (100%) newborns were dried immediately after birth and the temperature was recorded among 20 (83.3%) of the babies with lost to follow up of 4 (16.7%) babies due to shifting to NICU for intensive care. During the second phase, among 720 babies that were delivered, 590 (81.9%) received skin-to-skin care for minimum of half hour due to rapid turnover of patients for delivery in labor room. Breastfeeding was initiated within one hour after birth in 593 babies (82.3%). Temperature was recorded among 528 (73.3%) babies with 37 (5.1%) shifted to NICU. Hypothermia was observed in 10 babies (1.4%) during this phase. Practical Implications: Hypothermia is a preventable cause of neonatal mortality which can be easily prevented by training of health care providers, midwives, and lady health visitors to incorporate components of essential newborn care in their medical practice. Conclusion: Implementation of POQCI was found to be highly applicable yielding good response. Keywords: Newborn, hypothermia, immediate drying, point of care quality improvement, neonatal intensive care unit.
{"title":"A Point of Care Quality Improvement Initiative for Enhancing Immediate Drying of Babies and Prevention of Hypothermia in Labor Room, Nishtar Medical University, Multan Pakistan","authors":"Asma Akhter, H. Bashir, Summaira Perveen, Sajilah Karim, A. Khakwani, Mirab Badar, Huma Quddussi","doi":"10.53350/pjmhs221610302","DOIUrl":"https://doi.org/10.53350/pjmhs221610302","url":null,"abstract":"Objective: To find out the current status of prevention of neonatal hypothermia by firstly, initialization of immediate drying and skin to skin contact of all newborns delivered by spontaneous vaginal delivery, and secondly, to initiate early breast feeding. Methodology: This was an observational study carried out in labor room of Gyne Unit 1, Nishtar Medical University (NMU) and Hospital, Multan Pakistan from April to September 2019. Based on “Point of Care Quality Improvement (POCQI)” guidelines, Initially, data were collected for 4 weeks during morning shift (phase 1) utilizing 2 indicators i-e immediate drying and number of babies who developed hypothermia within one hour of birth. Data were analyzed; results interpreted, and necessary modifications made. After implementation of changes further data was collected for 24 hours shift of gyne unit 1 for the rest of study period including additional indicators i.e., initiation of early breastfeeding and skin to skin contact. Results: A total of 744 babies delivered over a period of six months during this initiative, which was carried out in 2 phases, the phase-1 comprised of four weeks and included study of 24 babies and the phase 2 included 720 babies over five months. During phase-1, all 24 (100%) newborns were dried immediately after birth and the temperature was recorded among 20 (83.3%) of the babies with lost to follow up of 4 (16.7%) babies due to shifting to NICU for intensive care. During the second phase, among 720 babies that were delivered, 590 (81.9%) received skin-to-skin care for minimum of half hour due to rapid turnover of patients for delivery in labor room. Breastfeeding was initiated within one hour after birth in 593 babies (82.3%). Temperature was recorded among 528 (73.3%) babies with 37 (5.1%) shifted to NICU. Hypothermia was observed in 10 babies (1.4%) during this phase. Practical Implications: Hypothermia is a preventable cause of neonatal mortality which can be easily prevented by training of health care providers, midwives, and lady health visitors to incorporate components of essential newborn care in their medical practice. Conclusion: Implementation of POQCI was found to be highly applicable yielding good response. Keywords: Newborn, hypothermia, immediate drying, point of care quality improvement, neonatal intensive care unit.","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125084240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hina B. Shah, S. Ahmed, Sadaf Talha, Sumbul Ayaz, T. Saeed, Marium Irshad
Objective: The current study aimed to evaluate oral health related habits, knowledge, and frequency of dental floss use among undergraduate medical and dental students. Methods: A cross-sectional study was undertaken at two institutes, Sindh Institute of Oral Health Sciences (SIOHS) and Sindh Medical College (SMC) of Jinnah Sindh Medical University (JSMU), Karachi, Pakistan, between March to May 2022. All undergraduate medical and dental students irrespective of gender, cast, creed, or socioeconomic status were eligible to partake in the study. The data on demographics including the age, gender, primary way of cleaning teeth, frequency of dental flossing, general oral health habits, assessment of knowledge of interdental cleaning aids etc. were recorded in a structured questionnaire. Results: The majority of the students acknowledged the importance of the role of students in promoting dental floss use among the community. Years of study in Bachelor of Dental Surgery (BDS) students was significantly associated with cleaning frequency (p < 0.0001) and primary cleaning method (p = 0.001). Interdental cleaning aid awareness, frequency of interdental cleaning, issues from not cleaning the interdental spaces, the role and use of dental floss were all significantly correlated with year of study among BDS students. Use of secondary methods was significantly associated with years of study among Bachelor of Medicine, Bachelor of Surgery (MBBS) students (p < 0.001). Conclusion: The present study concluded that years of study significantly correlated with the knowledge, awareness, and habits of dental students with respect to dental flossing. Keywords: dental hygiene, dental floss, interdental cleaning, oral health, dentist, medicine
{"title":"Oral Health Related Habits, Knowledge, and Frequency of Dental Floss use among Undergraduate Medical and Dental Students in a Public Health Sector University in Pakistan: A Comparative Study","authors":"Hina B. Shah, S. Ahmed, Sadaf Talha, Sumbul Ayaz, T. Saeed, Marium Irshad","doi":"10.53350/pjmhs221610274","DOIUrl":"https://doi.org/10.53350/pjmhs221610274","url":null,"abstract":"Objective: The current study aimed to evaluate oral health related habits, knowledge, and frequency of dental floss use among undergraduate medical and dental students. Methods: A cross-sectional study was undertaken at two institutes, Sindh Institute of Oral Health Sciences (SIOHS) and Sindh Medical College (SMC) of Jinnah Sindh Medical University (JSMU), Karachi, Pakistan, between March to May 2022. All undergraduate medical and dental students irrespective of gender, cast, creed, or socioeconomic status were eligible to partake in the study. The data on demographics including the age, gender, primary way of cleaning teeth, frequency of dental flossing, general oral health habits, assessment of knowledge of interdental cleaning aids etc. were recorded in a structured questionnaire. Results: The majority of the students acknowledged the importance of the role of students in promoting dental floss use among the community. Years of study in Bachelor of Dental Surgery (BDS) students was significantly associated with cleaning frequency (p < 0.0001) and primary cleaning method (p = 0.001). Interdental cleaning aid awareness, frequency of interdental cleaning, issues from not cleaning the interdental spaces, the role and use of dental floss were all significantly correlated with year of study among BDS students. Use of secondary methods was significantly associated with years of study among Bachelor of Medicine, Bachelor of Surgery (MBBS) students (p < 0.001). Conclusion: The present study concluded that years of study significantly correlated with the knowledge, awareness, and habits of dental students with respect to dental flossing. Keywords: dental hygiene, dental floss, interdental cleaning, oral health, dentist, medicine","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130262490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Masud, S. Azhar, Aliya Raza, Madiha Rasheed, Ammara Riaz, Afham Shahid
Objective: To record the frequency of dental erosion (DE) in patients with Gastro esophageal Reflux Disease (GERD). Methodology: The research included a total of one hundred patients who had been diagnosed with gastro esophageal reflux disease. Duration of study was 3 months from July, 2022 to September, 2022. Patients who presented with a digestive system illness in which stomach acid splashed over the bottom of the esophagus met the criteria for a diagnosis of GERD, which we utilized to make the diagnosis. It manifested itself in the form of a strong burning feeling in the chest, which often occurred after meals and typically occurred many times each week. Endoscopy and the patients' medical histories were used to make the diagnosis. For the purpose of making a tooth erosion diagnosis, GERD patients were evaluated presenting in the Madinah teaching hospital Faisalabad. It was shown that individuals who suffered from GERD had a significantly higher incidence of tooth erosion. Results: In our study, 46(46%) cases were between 30-45 years of age while 54(n=54) were between 46-60 years of age, mean age was calculated as 46.14+11.85 years. Gender distribution shows that 51(51%) were male while 49(49%) were females. DE was recorded in 34(34%) while 66(66%) had no findings of the morbidity; we found no significant difference in age and gender. Conclusion: Patients with gastroesophageal reflux disease often have dental erosion as a presenting symptom (GERD). Screening individuals with GERD for tooth erosion is crucial for identifying and treating instances timely to enhance patients' quality of life. Keywords: Gastro esophageal Reflux Disease (GERD), Adults, Dental Erosion (DE)
{"title":"Dental Erosions: A Manifest of Gastroesophageal Reflux Disease (GERD)","authors":"M. Masud, S. Azhar, Aliya Raza, Madiha Rasheed, Ammara Riaz, Afham Shahid","doi":"10.53350/pjmhs221610464","DOIUrl":"https://doi.org/10.53350/pjmhs221610464","url":null,"abstract":"Objective: To record the frequency of dental erosion (DE) in patients with Gastro esophageal Reflux Disease (GERD). Methodology: The research included a total of one hundred patients who had been diagnosed with gastro esophageal reflux disease. Duration of study was 3 months from July, 2022 to September, 2022. Patients who presented with a digestive system illness in which stomach acid splashed over the bottom of the esophagus met the criteria for a diagnosis of GERD, which we utilized to make the diagnosis. It manifested itself in the form of a strong burning feeling in the chest, which often occurred after meals and typically occurred many times each week. Endoscopy and the patients' medical histories were used to make the diagnosis. For the purpose of making a tooth erosion diagnosis, GERD patients were evaluated presenting in the Madinah teaching hospital Faisalabad. It was shown that individuals who suffered from GERD had a significantly higher incidence of tooth erosion. Results: In our study, 46(46%) cases were between 30-45 years of age while 54(n=54) were between 46-60 years of age, mean age was calculated as 46.14+11.85 years. Gender distribution shows that 51(51%) were male while 49(49%) were females. DE was recorded in 34(34%) while 66(66%) had no findings of the morbidity; we found no significant difference in age and gender. Conclusion: Patients with gastroesophageal reflux disease often have dental erosion as a presenting symptom (GERD). Screening individuals with GERD for tooth erosion is crucial for identifying and treating instances timely to enhance patients' quality of life. Keywords: Gastro esophageal Reflux Disease (GERD), Adults, Dental Erosion (DE)","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122876893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zabit Khan , Naibzai, Abeera Afzal Buzdar, M. Khalid, Najma Fatima, Nimrah Khalid, Zarmast Khan
Background and Aim: Globally, congenital anomalies (CA) are a major contributing factor for neonate’s admission in NICU causing neonatal morbidity and mortality particularly in developing countries. Congenital anomalies generally indicate the morphogenesis defect in an early neonate’s life. The leading cause for perinatal mortality is congenital anomalies that arise with advancement of delivery and care for newborn babies. The present study aimed to evaluate the prevalence and pattern of congenital anomalies among neonates admitted to neonatal unit. Methodology: This retrospective study was carried out on 1620 neonates (newborns to age 28 days) admitted to the neonatal unit of Services Hospital, Lahore from April 2020 to March 2022. The incidence, risk factors, and pattern of congenital anomalies were measured. Detailed examinations such as radiological, laboratory, ultrasonography, and echocardiography were recorded. Different outcomes such as hospital stay, morbidity, and mortality were determined with 95% confidence intervals. SPSS version 25 was used for data analysis. Results: Of the total 1620 admitted neonates, the prevalence of neonates with congenital anomalies were 112 (6.9%). Out of 112 neonates diagnosed with congenital anomalies, 64 (57.1%) were male and 48 (42.9%) were females. The incidence of cesarean and other modes of delivery were 74 (66%) and 38 (34%) respectively. Cardiovascular system malformation was the most prevalent affected system in 36 (31.9%) neonates followed by central nerve system 28 (25%), genitourinary system 19 (17%), musculoskeletal system 16 (14.3%), gastrointestinal tract 6 (5.4%), digestive system 4 (3.6%), and syndromes and skin 3 (2.7%). Congenital anomalies were significantly increasing over time. The incidence of discharged, referred to higher centers for intervention, and expired babies were 77 (68.8%), 19 (16.7%), and 16 (14.3%) respectively. Conclusion: The present study found that the prevalence of congenital anomalies was 6.9%. Cardiovascular system malformation was the most prevalent congenital anomaly followed by the central nerve system. The overall mortality rate was 14.3% caused by congenital anomalies. A better health care strategies and management must be developed in terms of early detection, supplementation facilitation, decreasing drug usage, and better antenatal care to prevent the impacts of congenital anomalies on neonates. Keywords: Prevalence, Pattern, Congenital anomalies, neonates
{"title":"Prevalence and Pattern of Congenital Malformations among Neonates in the Neonatal Unit of a Tertiary Care Hospital","authors":"Zabit Khan , Naibzai, Abeera Afzal Buzdar, M. Khalid, Najma Fatima, Nimrah Khalid, Zarmast Khan","doi":"10.53350/pjmhs221610372","DOIUrl":"https://doi.org/10.53350/pjmhs221610372","url":null,"abstract":"Background and Aim: Globally, congenital anomalies (CA) are a major contributing factor for neonate’s admission in NICU causing neonatal morbidity and mortality particularly in developing countries. Congenital anomalies generally indicate the morphogenesis defect in an early neonate’s life. The leading cause for perinatal mortality is congenital anomalies that arise with advancement of delivery and care for newborn babies. The present study aimed to evaluate the prevalence and pattern of congenital anomalies among neonates admitted to neonatal unit. Methodology: This retrospective study was carried out on 1620 neonates (newborns to age 28 days) admitted to the neonatal unit of Services Hospital, Lahore from April 2020 to March 2022. The incidence, risk factors, and pattern of congenital anomalies were measured. Detailed examinations such as radiological, laboratory, ultrasonography, and echocardiography were recorded. Different outcomes such as hospital stay, morbidity, and mortality were determined with 95% confidence intervals. SPSS version 25 was used for data analysis. Results: Of the total 1620 admitted neonates, the prevalence of neonates with congenital anomalies were 112 (6.9%). Out of 112 neonates diagnosed with congenital anomalies, 64 (57.1%) were male and 48 (42.9%) were females. The incidence of cesarean and other modes of delivery were 74 (66%) and 38 (34%) respectively. Cardiovascular system malformation was the most prevalent affected system in 36 (31.9%) neonates followed by central nerve system 28 (25%), genitourinary system 19 (17%), musculoskeletal system 16 (14.3%), gastrointestinal tract 6 (5.4%), digestive system 4 (3.6%), and syndromes and skin 3 (2.7%). Congenital anomalies were significantly increasing over time. The incidence of discharged, referred to higher centers for intervention, and expired babies were 77 (68.8%), 19 (16.7%), and 16 (14.3%) respectively. Conclusion: The present study found that the prevalence of congenital anomalies was 6.9%. Cardiovascular system malformation was the most prevalent congenital anomaly followed by the central nerve system. The overall mortality rate was 14.3% caused by congenital anomalies. A better health care strategies and management must be developed in terms of early detection, supplementation facilitation, decreasing drug usage, and better antenatal care to prevent the impacts of congenital anomalies on neonates. Keywords: Prevalence, Pattern, Congenital anomalies, neonates","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131513011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：